scholarly journals Complex respiratory and motor rehabilitation program in a patient with post-pulmonary tuberculosis conditions and multiple sequelae after SARS-CoV-2 infection: case report

2021 ◽  
pp. 301-305
Author(s):  
Cristina DAIA ◽  
Anca IONESCU ◽  
Elena Valentina IONESCU ◽  
Mădălina Gabriela ILIESCU ◽  
Liliana Elena STANCIU ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Motor Impairment ◽  
Lower Lobe ◽  
Rehabilitation Program ◽  
Lower Limbs ◽  
Exertional Dyspnea ◽  
Locomotor Disability ◽  
Family Reintegration ◽  
Medical Issues ◽  
Respiratory Parameters

Introduction: A great variety of medical issues can occur after the COVID-19 infection including fatigue, muscle weakness, locomotor disability, self-care dysfunction, polyneuropathy, persistent dyspnea on exertion and a hypercoagulable state. Materials and methods: This paper presents the case of a nonsmoker 49-year-old male with right lung lower lobe lobectomy for post tuberculosis bronchiectasis and diabetes mellitus, who developed multiple serious physicals, neurological, hematological and respiratory consequences, related to critical COVID-19 infection and prolonged hospitalization, Results: A favorable evolution of the patient’s respiratory sequels and motor impairment on both lower limbs was noticed after a complex individualized rehabilitation program started in the post COVID-19 Rehabilitation Department of Balneal and Rehabilitation Sanatorium, Techirghiol, Romania, consisting in better functional parameters and exercise tolerance, significant improvement in daily activities, remission of exertional dyspnea, social and family reintegration. Conclusions: multidisciplinary approach and complex individualized programs of rehabilitation is required after a critical form of COVID in a patients known with tuberculosis, and other complex pathologies, in order to restore physical function and mobility and optimize respiratory parameters. Keywords: COVID-19, Rehabilitation, Tuberculosis,

Rehabilitation in Devica’s Syndrome. Case Report

2021 ◽  
Vol 63 (1) ◽  
pp. 78-83
Author(s):  
Agnieszka Maruszewska ◽  
Lech Panasiuk ◽  
Katarzyna Bryzek-Michalak
Keyword(s):  
Case Report ◽  
Multidisciplinary Approach ◽  
Treatment Process ◽  
Rehabilitation Program ◽  
Lower Limbs ◽  
Functional Tests ◽  
Beneficial Effects ◽  
Devic’S Syndrome ◽  
Strengthening Exercise ◽  
Comprehensive Rehabilitation

Introduction: Devic’s syndrome also known as neuromyelitis optica is an autoimmune disease of central nervous system (CNS).It has an inflammatory, demyelizatory, chronic and relapsing nature, where ones own immune system attacks the spinal cord and optic nerves. Material and Methods: The authors presented a case report of a 54-year-old woman diagnosed with Devic’s syndrome 2 years ago. The physiotherapeutic examination revealed: visual and balance disturbances, decrease in muscle strength of upper and lower limbs, unsteady and shaky gait with a need to use a zimmer frame. At the start and at the end of a therapy, to objectively monitor the progress of rehabilitation treatment, a number of functional tests were used that included: Barthel Index, Brunnstrom’s test, Rankin Scale, Ashworth’s scale, Lovett’s test and a timed 20m walk. In physiotherapeutic treatment process patterns and techniques of PNF (prioprioceptive neuromuscular facilitation) ware used as well as exercise to correct muscles tone and strengthening exercise of trunk and lower limbs. Results: As a result of applying a comprehensive rehabilitation approach an increase of muscles strength of upper and lower limbs was obtained (Lovett’s scale R/L: shoulder 5/5, elbow 5/5, hand 5/5, hip 4+/4+, knee 4+/4+, foot 4+/4+). In addition all postural muscles gained in strength and an improvement in hands dexterity, body coordination and balance was noticed. Conclusion: Multidisciplinary approach and an individually selected rehabilitation program proves to show beneficial effects in a treatment process of patients with Devic’s syndrome.

A variant of the gene HARS detected in the clinical exome: etiology of a peripheral neuropathy undiagnosed for 20 years

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Raquel Lahoz Alonso ◽  
Paula Sienes Bailo ◽  
Jose Luis Capablo Liesa ◽  
Sara Álvarez de Andrés ◽  
Jose Luis Bancalero Flores ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Neurological Disease ◽  
Motor Impairment ◽  
Lower Limbs ◽  
Case Presentation ◽  
Genetic Sequencing ◽  
Charcot Marie Tooth ◽  
Sensory Motor ◽  
Exacerbation Of Symptoms ◽  
Over Time

AbstractObjectivesDescribe a case with axonal Charcot-Marie-Tooth (CMT) type 2W, a neurological disease characterized by peripheral neuropathy typically involving the lower limbs and causing gait alterations and distal sensory-motor impairment.Case presentationWe report this case, where the application of massive genetic sequencing (NGS) with clinical exome in a molecular genetics laboratory enabled to detect the presence of candidate variants of the clinic of the patient.ConclusionsThe variant detected in HARS gene suggests that this variant could be causative of the symptoms of the patient, who went undiagnosed for 20 years and experienced an exacerbation of symptoms over time.

Bilateral Changes in Ground Reaction Forces in Patients with Unilateral Anterior Cruciate Ligament Deficiency During Stair Locomotion

2011 ◽  
Vol 27 (3) ◽  
pp. 437-445 ◽  
Author(s):  
H.-C. Lin ◽  
H.-C. Hsu ◽  
T.-W. Lu
Keyword(s):  
Cruciate Ligament ◽  
Ground Level ◽  
Rehabilitation Program ◽  
Lower Limbs ◽  
Control Group ◽  
Ground Reaction Forces ◽  
Acl Deficiency ◽  
Stair Ascent ◽  
Reaction Forces ◽  
Stair Locomotion

ABSTRACTStair locomotion is an important but challenging functional activity for people with lower limb pathology. This study aimed to investigate the bilateral changes in force-bearing on lower limbs during stair locomotion in patients with unilateral ACL deficiency. The ground reaction forces (GRF) were collected from three force platforms: One at ground level in front of a 5-step stair and two on the first two steps respectively. Parameters in vertical and anterior-posterior GRF were extracted and compared between the ACL-deficient (ACLD) and control groups. The ACLD group showed significantly slower stepping cadences in both stair ascent and stepping down to the ground (p < 0.05). The vertical GRF in the ACLD group demonstrated smaller peak forces but larger minimum forces between the two peaks than those in the control group during both stair ascent and descent. Significantly reduced anterior propulsive forces and push-off rates in the late stance were also found in both limbs of the ACLD group (p < 0.05). The slower cadences and reduced force-bearing on the affected limb suggested a protective strategy was adopted. However, the anterior loading parameters in the early stance on the unaffected limb demonstrated different adaptations with significantly larger magnitudes during stair ascent but reduced magnitudes during stair descent (p < 0.05). Similar results were also found in the weight- transferring strategies between legs in consecutive steps with a significantly larger percentage of lift-up forces but a smaller percentage of impact forces on the leading unaffected limb. The results of this study indicated a cautious force-bearing strategy and bilateral adaptation were apparent in the patients with unilateral ACL deficiency. This information may provide a safety guideline for the patients and be helpful for a better use of the stair tasks as part of a rehabilitation program.

scholarly journals Bone Infarct as an Indicator of Acute Spinal Ischaemia

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Laura López-Viñas ◽  
Kary Leonisa Quiñones-Coneo ◽  
Raquel Buenache-Espartosa ◽  
Juan Salvador Martínez-San-Millán ◽  
Gustavo Lorenzo-Sanz
Keyword(s):  
Spinal Cord ◽  
Laboratory Tests ◽  
Clinical Case ◽  
Cardiovascular Surgery ◽  
Rehabilitation Program ◽  
Lower Limbs ◽  
Resonance Imaging ◽  
Spinal Cord Infarct ◽  
Motor Strength ◽  
Bone Infarct

Acute spinal cord infarct in childhood is extremely rare, generally secondary to spinal/cardiovascular surgery or severe vertebral injuries. However, spontaneous spinal cord infarct cases have been described. We present a clinical case of a teenager who developed an acute weakness and paraesthesia in lower limbs after playing piggyback. Laboratory tests and MRI (magnetic resonance imaging) were normal. During her hospital admission, her motor strength improved. After 10 days, MRI was repeated, and a bone infarct was observed. She was medicated with acetylsalicylic acid, and she completed a rehabilitation program.

Pelvic Pain and Floor Dysfunction

2018 ◽  
Author(s):  
Danielle Sarno ◽  
Farah Hameed
Keyword(s):  
Physical Therapy ◽  
Pelvic Floor ◽  
Pelvic Pain ◽  
Multidisciplinary Approach ◽  
Rehabilitation Program ◽  
Painful Bladder ◽  
Integral Role ◽  
Comprehensive Rehabilitation ◽  
Irritable Bowel ◽  
Tract Infections

Chronic pelvic pain is defined as persistent pain perceived in structures related to the anatomic pelvis (lower abdomen below the umbilicus) of either women or men for greater than 6 months. The etiology may be related to gynecologic, urologic, gastrointestinal, musculoskeletal, and neurologic causes. Pelvic pain and floor dysfunction often are associated with a musculoskeletal disorder related to the pelvic girdle, spine, or hip. Myofascial pelvic pain may be related to other diagnoses, such as depression, irritable bowel syndrome, endometriosis, constipation, painful bladder syndrome, and chronic urinary tract infections. A thorough history and clinical examination, including an internal pelvic floor musculoskeletal examination, can help identify the underlying etiology. A multidisciplinary approach to management is essential. Pelvic floor physical therapy plays an integral role. Other treatments, such as medications, complementary therapies, and injections, may be used in conjunction with physical therapy to facilitate a comprehensive rehabilitation program and manage symptoms.

scholarly journals The Impact of Walking Exercises and Resistance Training upon the Walking Distance in Patients with Chronic Lower Limb Ischaemia

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Maria Szymczak ◽  
Grzegorz Oszkinis ◽  
Marian Majchrzycki
Keyword(s):  
Resistance Training ◽  
Intermittent Claudication ◽  
Rehabilitation Program ◽  
Lower Limbs ◽  
Walking Distance ◽  
Group Training ◽  
Limb Ischaemia ◽  
Walking Test ◽  
Resistance Exercises ◽  
The Impact

Objective. The objective of this paper is to compare the impact of supervised walking and resistance training upon the walking distance in PAD patients. Materials and Methods. The examination involved 50 PAD patients at the 2nd stage of the disease according to Fontaine’s scale. The participants were randomly allocated to two groups: one exercising on the treadmill (n=24) and one performing resistance exercises of lower limbs (n=26). Results. The 12-week program of supervised rehabilitation led to a significant increase in the intermittent claudication distance measured both on the treadmill and during the 6-minute walking test. The group training on the treadmill showed a statistically significant increase of the initial claudication distance (ICD) and the absolute claudication distance (ACD) measured on the treadmill, as well as of ICD and the total walking distance (TWD) measured during the 6-minute walking test. Within the group performing resistance exercises, a statistically significant improvement was observed in the case of parameters measured on the treadmill: ICD and ACD. Conclusions. The supervised rehabilitation program, in the form of both walking and resistance exercises, contributes to the increase in the intermittent claudication distance. The results obtained in both groups were similar.

scholarly journals Assessing the Share of Impaired Visual Function, Fine Motor Coordination and Visual-motor Integration in Dyslexic Children with the Eta/Mu Model

2019 ◽  
pp. 1-13
Author(s):  
Carlo Aleci ◽  
Francesca Vai
Keyword(s):  
Motor Coordination ◽  
Motor Impairment ◽  
Rehabilitation Program ◽  
Second Order ◽  
Motor Domain ◽  
Fine Motor ◽  
Motor Deficits ◽  
First Order ◽  
Visual Motor Integration ◽  
Visual Motor

Aims: A computational model aimed to estimate the proportion of visual/motor deficits (first-order defects) and visual-motor abnormal integration (second-order defect) in dyslexic children is described. Study Design: Single-masked case-control study. Place and Duration of Study: Sample: Service of Neuro-Ophthalmology, University of Turin, between December 2017 and November 2018. Methodology: Twenty subjects (age 8-10) were administered a set of tests that recruit the visual and motor domain in different proportions. The score obtained in each trial is weighed by the correspondent share of visuoperceptive and motor recruitment. This way two indexes are obtained: Eta (h) and Mu (m), that quantify the expected and estimated damage of the two functions across the range of average performance. The difference between the expected and estimated level of damage in the two domains represents the quota of selective visuoperceptive / motor impairment of the subject. In turn, no or negligible difference in the presence of abnormal z-score would reveal impaired visual-motor integration with no evident visual or motor damage. Results: The model detected a prevalent first-order defect in the visuo perceptive or motor domain in 58% of the cases (visuo perceptive alteration: 27%, motor alteration: 73%), and a prevalent second-order defect in the remaining 42% of the subjects. Internal consistency was adequate for research and screening purpose (Cronbach’s coefficient alpha: from 0.77 to 0.84). Conclusion: The Eta/Mu model seems a promising tool to detect cases of visual and motor alteration as well as the level of visual-motor integration in dyslexic children. Further effort is needed to improve test-retest reliability by examining larger samples, so as to make it suitable to customize the rehabilitation program of children suffering from learning disabilities.

scholarly journals Effects of Whole-Body Vibration-Assisted Training on Lower Limb Blood Flow in Children With Myelomeningocele

2021 ◽  
Vol 9 ◽  
Author(s):  
Andrzej Szopa ◽  
Małgorzata Domagalska-Szopa ◽  
Andrzej Siwiec ◽  
Ilona Kwiecień-Czerwieniec
Keyword(s):  
Blood Flow ◽  
Range Of Motion ◽  
Lower Limb ◽  
Whole Body Vibration ◽  
Rehabilitation Program ◽  
Functional Mobility ◽  
Lower Limbs ◽  
Whole Body ◽  
Body Vibration ◽  
Tibial Arteries

This study investigated the effectiveness of whole-body vibration (WBV) training incorporated into a conventional physiotherapy (PT) program (WBV-assisted training) in improving blood flow in the lower limbs and range of motion in the lower limb joints of children with myelomeningocele (MMC). A total of 31 children with MMC (7–15 years old) underwent a 6 weeks treatment program consisting of 2 weeks of conventional PT followed by 4 weeks of WBV-assisted training. The assessment comprised two parts: evaluation of lower limb joint range of motion and Doppler ultrasonography of the superficial femoral, popliteal, and anterior tibial arteries and was performed three times for each of the participants (at baseline, after 10 sessions of PT but before WBV-assisted training, and after 20 sessions of WBV-assisted training). Our results showed that WBV-assisted training significantly improved lower limb circulation in patients with MMC, increasing velocity and reducing resistivity in all tested arteries. Moreover, WBV-assisted training alleviated lower-extremity contractures, especially of the knee. Thus, WBV-assisted training is effective as an adjunctive rehabilitation program for improving functional mobility in children with MMC.

scholarly journals DIGITAL ULCERS AND MULTIPLE AMPUTATIONS IN A SYSTEMIC SCLEROSIS PATIENT

2017 ◽  
Vol 26 (4) ◽  
pp. 173-178
Author(s):  
Laura Groseanu ◽  
◽  
Ina Cambur ◽  
Andra Balanescu ◽  
Ruxandra Ionescu ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Lower Extremity ◽  
Multidisciplinary Approach ◽  
Macrovascular Disease ◽  
Lower Limbs ◽  
Digital Ulcers ◽  
Upper Limbs ◽  
Course Of Disease ◽  
Diffuse Cutaneous Systemic Sclerosis ◽  
Systemic Sclerosis Patient

We are presenting the case of a 48 years old female diagnosed at the age of 28 with diffuse cutaneous systemic sclerosis. During the course of disease, despite the vasodilatator treatments and immunosuppresion for visceral involvement, the patient developed multiple infected digital ulcers both in the upper limbs and in the lower limbs, which complicated with wet gangrene, requiring transmetatarsal amputations. At that time, a macrovascular disease or a prothrombotic condition were excluded. Patient also developed infected nondigital lower extremity ulcers, which slowly healed after Alprostadil treatment. The evolution of our patient‘s disease demonstrate that the management of scleroderma vasculopathy represent a challange and a multidisciplinary approach is needed.

scholarly journals Short-term Effects of a Three-week Inpatient Post-COVID-19 Pulmonary Rehabilitation Program - a Prospective Observational Study

2021 ◽  
Author(s):  
Markus C. Hayden ◽  
Matthias Limbach ◽  
Michael Schuler ◽  
Steffen Merkl ◽  
Gabriele Schwarzl ◽  
...  
Keyword(s):  
Lung Function ◽  
Observational Study ◽  
Pulmonary Rehabilitation ◽  
Prospective Observational Study ◽  
Rating Scales ◽  
Clinical Manifestations ◽  
Rehabilitation Program ◽  
Physical Capacity ◽  
Effect Sizes ◽  
Exertional Dyspnea

Abstract Background:The clinical course of coronavirus disease 2019 (COVID-19) varies distinctly. Particularly after severe or critical courses, i.e., after hospitalization, clinical manifestations frequently persist after the acute phase. However, symptoms may also persist after initially milder courses that can be treated in an outpatient setting. For patients who remain symptomatic after COVID-19, pulmonary rehabilitation (PR) is recommended. However, only few studies investigated the effectiveness of PR, especially considering different disease courses. The main objective was to evaluate the feasibility, safety, and efficacy of post-COVID-19 PR.Methods:A total of 120 post-COVID-19 patients who were referred to the Bad Reichenhall Clinic between April 2020 and January 2021 were asked to participate in this prospective observational study. PR was tailored to each patient’s individual needs and was based on the current recommendations. The primary outcome dyspnea was assessed with numerical rating scales and the modified Medical Research Council (mMRC) dyspnea scale. Secondary outcomes included other symptoms such as cough and sputum; physical capacity; lung function; fatigue; quality of life (QoL); depression; and anxiety. Furthermore, patients rated the overall effectiveness of PR and their subjective change in health status.Results:A total of 108 patients (mean age 55.6±10.1 years, 45.4% female) were included and were assigned to 3 groups depending on the referral mode (A: severe acute; B: severe after interval, C: mild after interval). At the end of PR, we detected improvements in the intensity of exertional dyspnea, physical capacity, QoL, fatigue, and depression in the overall group, with large effect sizes (Cohen’s d>0.8). Moderate effect sizes (0.5≤d<0.8) were found for resting dyspnea and the mMRC-dyspnea scale. Cohen’s d>0.4 was found for vital capacity, forced expiratory volume in one second, partial oxygen pressure, and anxiety. Significant but rather small effect sizes (0.2<d<0.4) were found for cough, sputum, pain, and other lung function parameters.Conclusions:PR is feasible, safe, and effective after acute COVID-19, which was true for all 3 groups analyzed, with a trend toward greater efficacy after severe courses of COVID-19 and an earlier start of PR after acute COVID-19. Therefore, all post-COVID-19 patients who remain symptomatic should be offered PR.Trial registration: German Clinical Trials Register, DRKS00023180. Registered 01 September 2020 – Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023180

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